Induction of anesthesia and intubation using a laser tube by the anesthesia colleagues. Then insertion of the Da Vinci retractor and inspection of the tumor region. A 2-3 cm large tumor is found at the lower pole of the tonsil with transition to the base of the tongue. The robotic arms are then advanced and tumor resection begins at the cranial edge. The tumor is cut around, taking most of the tonsil and part of the base of the tongue and the glossotonsillar fold with it. Basally, the soft tissues of the neck are reached very far, so that the neck fat and also parts of the submandibular gland are exposed and pulsating vessels are palpable and visible through the fat. For this reason, a neck dissection is not performed in this procedure, as otherwise a thorough defect would occur. Due to the extent of the defect and recurrent bleeding during the tumor resection, the decision was made to perform a small tracheotomy. First, however, the neck dissection was performed on the left side by <CLINICIAN_NAME>. For this, skin incision in the usual manner. Exposure of the sternocleidomastoid muscle. Exposure of the submandibular gland. Exposure of the digastric muscle. Exposure of the omohyoid muscle. Showing the cervical vascular sheath. Exposure of the accessorius nerve, hypoglossus and cervical anus. Then evacuation of levels IIa to IV while sparing the plexus branches. Insertion of a Redon drainage and two-layer wound closure. Finally, the tracheotomy is performed in the usual manner. For this, skin incision below the cricoid cartilage. Dissection down to the thyroid isthmus. Dissection of the thyroid isthmus. Exposure of the anterior wall of the trachea and creation of a visor tracheotomy between the 2nd and 3rd tracheal cartilage. Creation of a mucocutaneous anastomosis and reintubation to a 9 mm tracheal cannula. The patient was admitted to the intensive care unit postoperatively and was given a nasogastric tube to be fed for 5 days. Then TE diet and planning of neck dissection on the right side after 3-4 weeks.